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Contributors

Jan Berting, Erzébet Bukodi, Ton Korver, Pekka Kosonen, Laurent J.G. van der Maesen, An Marchal, François Nectoux, Jozef Pacolet, Heloísa M. Persista, Pedro Persista, Péter Róbert, Jukka Vänskä
2003 European Journal of Social Quality  
Jukka Vänskä is attached to the University of Helsinki.  ... 
doi:10.3167/146179103781796947 fatcat:cyjn7mupirbibd6krpi3h56qsu

What predicts doctors' satisfaction with their chosen medical specialty? A Finnish national study

Teppo J. Heikkilä, Harri Hyppölä, Jukka Vänskä, Hannu Halila, Santero Kujala, Irma Virjo, Markku Sumanen, Elise Kosunen, Kari Mattila
2016 BMC Medical Education  
Jukka Vänskä has educational background in social sciences (M.Soc.Sc). He works as research chief at the Finnish Medical Association.  ...  Vänskä has published several articles on physicans' education, employment and working conditions.  ... 
doi:10.1186/s12909-016-0643-z pmid:27114239 pmcid:PMC4845435 fatcat:bndw3muxszgvbitgluiza7yf5e

Factors important in the choice of a medical career: a Finnish national study

Teppo J. Heikkilä, Harri Hyppölä, Jukka Vänskä, Tiina Aine, Hannu Halila, Santero Kujala, Irma Virjo, Markku Sumanen, Kari Mattila
2015 BMC Medical Education  
Applying for medical school is the first and also one of the most important career choices a physician makes. It is important to understand the reasons behind this decision if we are to choose the best applicants for medical schools and enable them to pursue satisfying careers. Methods: Respondents to the Finnish Junior Physician 88, Physician 1998 and Physician 2008 studies were asked: "To what extent did the following factors influence your decision to apply for medical school?" In 1998 and
more » ... 08 the respondents were also asked: "If you were starting your studies now, would you start studying medicine?" and had to answer "Yes" or "No". The odds ratios for the answer "No" were tested using logistic regression models. Results: "Interest in people" was the main motive for starting to study medicine. "Good salary" and "Prestigious profession" were more important motives for males and "Vocation" and "Interest in people" for females. There were some significant changes in the motives for entering medicine in the 20-year period between studies. "Vocation" and "Wide range of professional opportunities" as important motives for entering medicine predicted satisfaction with the medical profession. Discussion: Strong inner motivation may indicate the ability to adapt to the demands of work as a physician. Conclusions: Medical schools should try to select those applicants with the greatest vocational inclination towards a medical career.
doi:10.1186/s12909-015-0451-x pmid:26438163 pmcid:PMC4594741 fatcat:paokqjpz45dpvlghluywez6bsm

Validating the National Usability-focused HIS Scale (NuHISS) for Physicians (Preprint)

Hannele Hyppönen, Johanna Kaipio, Tarja Heponiemi, Tinja Lääveri, Anna-Mari Aalto, Jukka Vänskä, Marko Elovainio
2018 Journal of Medical Internet Research  
Problems in the usability of health information systems (HISs) are well acknowledged, but research still lacks a validated questionnaire for measuring and monitoring different dimensions of usability of HISs. Such questionnaires are needed not only for research but also for developing usability of HISs from the viewpoint of end-user experiences.
doi:10.2196/12875 pmid:31099336 pmcid:PMC6542250 fatcat:qrkmtuikufdx3nfhy33v2ghs24

Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians

Suvi Vainiomäki, Tarja Heponiemi, Jukka Vänskä, Hannele Hyppönen
2020 International Journal of Environmental Research and Public Health  
Electronic health records (EHRs) have an impact on physicians' well-being and stress levels. We studied physicians' experiences with EHRs and their experienced time pressure and self-rated stress by an electronic questionnaire sent to Finnish physicians aged under 65 in 2017. Our sample was 2980 physicians working in the public sector, health care centers (35.5%) or hospitals (64.5%). Experienced technical problems were positively associated with experienced time pressure, whereas
more » ... ess of the EHRs was negatively associated with experienced time pressure. Low perceived support for internal cooperation was associated with high levels of time pressure in hospitals. Those experiencing high levels of technical problems were 1.3 times more likely to experience stress compared to those experiencing low levels of technical problems. Better user-friendliness of the EHRs was associated with lower levels of self-rated stress. In both working environments but more strongly in primary health care, technical problems were associated with self-rated stress. Technical problems and user-friendliness of EHRs are the main factors associated with time pressure and self-rated stress. Health care environments differ in the nature of workflow having different demands on the EHRs. Developing EHR systems should consider the special needs of different environments and workflows, enabling better work well-being amongst physicians.
doi:10.3390/ijerph17134715 pmid:32630043 fatcat:hxzatamorrb7nnkkf5v5eaalte

National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability

Johanna Viitanen, Hannele Hyppönen, Tinja Lääveri, Jukka Vänskä, Jarmo Reponen, Ilkka Winblad
2011 International Journal of Medical Informatics  
Nykytila tutkimusten valossa THL ja Oulun yliopiston Finntelemedicun ovat seuranneet jo yli kymmenen vuoden ajan eTerveyden kehittymistä Suomessa [1], viimeisin tutkimus on vuodelta 2011. Sähköinen sairauskertomus on ollut jo pitkään kattavasti käytössä julkisessa terveydenhuollossa, liki yhtä hyvä tilanne on kuvantamisen ja päätöksenteon tuen suhteen. Alueellista tiedonvaihtoa on lähes kaikissa sairaanhoitopiireissä ja vähintään 70%:ssa terveyskeskuksista. Yksityinen sektori ei ole
more » ... ssa mukana joitakin lähete-palauteyhteyksiä lukuun ottamatta. Potilaiden sähköiset palvelut ovat alkutekijöissään. Meillä on edelläkävijän ongelma; kertomusjärjestelmämme ovat suurimmaksi osaksi 90-luvulta. Ne vaativat uusiutumista tai uusimista etenkin käytettävyyden [2] ja prosessituen puuttumisen takia. Lääkäriliitto ja THL ovat tutkineet lääkärien mielipidettä järjestelmien käytettävyydestä sekä alueellisen tiedonvaihdon sujuvuudesta [3], parantamisen varaa tuntuu olevan. Terveydenhuollon kansalliset sähköiset palvelut (Kanta) pyrkivät tuomaan potilastiedon hoitavien ammattilaisten sekä potilaan itsensä ulottuville standardimuodossa, järjestelmä-ja organisaatioriippumattomasti. Sähköinen resepti on jo koko julkisen sektorin käytössä, sen toiminnasta valmistellaan sekä potilaille että lääkäreille suunnattua kyselyä. Sähköisen potilastiedon arkiston käyttöönotto alkaa tänä syksynä. Kunhan nämä palvelut ovat vakiintuneet, tutkimuspanokset tulee kohdistaa niiden käyttöön ja vaikuttavuuteen. Mitä ulkomaiset tutkimukset meistä sanovat? EU on tehnyt eHealth Benchmarking -tutkimuksia, viimeksi julkaistut ovat 2009 perusterveydenhuollosta [4] ja 2011 erikoissairaanhoidosta [5] . Tutkimuksissa käytettyjen 13 indikaattorin mukaan Suomen terveyskeskukset ja sairaalat kuuluivat kärkikaartiin. Yhdysvaltalainen ITIF (The Information Technology & Innovation Foundation) totesi vuonna 2009 tutkimuksessaan [6] Suomen olevan Tanskan ja Ruotsin ohella eTerveyden johtava maa. Suomen menestyksen salaisuutena pidettiin mm laajaa tietotekniikan käyttöä ja kansalaisten luottamusta, varhain lanseerattua eTerveys-strategiaa (1996) ja sen pohjalta tehtyä standardointia, lainsäädäntöä ja kansallista rahoitusta. Tänä vuonna THL teetti STM:n pyynnöstä kansainvälisen arvioinnin Kanta-palveluista [7] . Arvioinnin suoritti EH-TEL (European Health Telematics Assosiation). Vahvuuksina todettiin mm. kansallinen arkkitehtuuri (keskitetty tietovarasto, jota potilastietojärjestelmät ja apteekkijärjestelmät käyttävät) sekä kerättävän tiedon laajuus ja rakenteisuus. Uudet työkalut mahdollistavat terveydenhuollon prosessien muutokset, lisäksi kerättyä tietoa voidaan käyttää mm hoidon laadun ja tulosten mittauksessa sekä kliinisten vaikutusten arvioinnissa. Arvioijat kannustivat panostamaan jatkossa toimintamallien muutokseen, jotta tehdyistä investoinneista saadaan hyöty irti. Muutokseen tarvitaan ennen kaikkea ammattilaisten ja kansalaisten aktiivista panosta. Uhkana nähtiin liika tieto, sen takia vain tarpeelliset asiat tulee dokumentoida. Myös tietoturvaan ja
doi:10.1016/j.ijmedinf.2011.06.010 pmid:21784701 fatcat:hasdps5rirc4vplsisdafyhaly

Health information exchange in Finland: Usage of different access types and predictors of paper use

Hannele Hyppönen, Sonja Lumme, Jarmo Reponen, Jukka Vänskä, Johanna Kaipio, Tarja Heponiemi, Tinja Lääveri
2019 International Journal of Medical Informatics  
Authors' contributions Hannele Hyppönen, Jarmo Reponen, Tinja Lääveri, Jukka Vänskä and Johanna Kaipio contributed to the questionnaire development, as well as revisions and approval of the manuscript.  ... 
doi:10.1016/j.ijmedinf.2018.11.005 fatcat:dxxpsig5jbecpgln3xg2w5gaa4

Amount of external CME in groups of specialties: a nation-wide survey among Finnish doctors

Arja Helin-Salmivaara, Mira Kajantie, Jukka Vänskä, Hannu Halila, Taina Autti, Juha P Turunen, Amos Pasternack
2009 BMC Research Notes  
Continuing medical education (CME) is an integral part of continuing professional development and a prerequisite for good quality in health care. We aimed to describe and analyse the number of days spent in formal CME outside the workplace by specialty among Finnish doctors of working age. Findings: The number of days in formal CME outside the workplace in 2005 reported by specialists was obtained from an annual postal survey, conducted by the Finnish Medical Association in March 2006, of all
more » ... rking-age doctors. Those who had attained their specialist degree before 2005 were included in the study. The 49 specialties were re-categorised into 15 groups. The mean reported number of days and 95% confidence intervals were calculated. Differences were analysed by Poisson regression adjusted for relevant covariates. The response rate to the question about CME was 70.2% (7,374) among specialists. The median age (interquartile range) of the respondents was 49 years (from 44 to 55 years), and 51.7% (3,810) were female. The mean reported number of days in CME was 8.8 (95% CI 8.7-9.0). Neurologists and surgery specialists participated in CME the most frequently (10.3 and 10.4 days) and ophthalmologists the least (7.6 days). In comparison with anaesthesiology and intensive care specialists, most specialists reported having significantly more formal CME, and no group reported having less. Conclusions: Significant variation was observed, and we therefore suggest studies seeking to account for this variation.
doi:10.1186/1756-0500-2-265 pmid:20038290 pmcid:PMC2804579 fatcat:z2utusjp5jg27enfeneun7h5h4

Where have all the GPs gone – where will they go? Study of Finnish GPs

Markku Sumanen, Tiina Aine, Hannu Halila, Teppo Heikkilä, Harri Hyppölä, Santero Kujala, Jukka Vänskä, Irma Virjo, Kari Mattila
2012 BMC Family Practice  
In this paper a specialist in general practice is referred to as a general practitioner (GP). In Finland only half of all GPs work as a health centre physician. The present aim was to establish what the working places of specializing and specialized physicians in general practice are, and where they assume they will work in the future. Methods: The study population comprised 5,357 physicians licensed in Finland during the years 1977-1996. Altogether 2,956 questionnaires were returned, a
more » ... rate of 55.2%. Those either specializing (GP trainees, n=133) or already having specialized (GPs, n=426) in general practice were included in the study. Respondents were asked what kind of physician's work they would most preferably do. They were further asked what work they assumed they would be doing in the year 2020. Results: Altogether 72% were working in public primary health centres and 14% in the private sector. Of GPs 53% and of GP trainees 70% would most preferably work in health centres. Of GPs 14% would most preferably work as private practitioners and 9% as occupational health physicians. Sixteen per cent assumed they would be working as private practitioners and 35% assumed they would be retired in the year 2020. Of GP trainees 57% assumed they would be working as health centre physicians in 2020. Conclusions: According to the present findings many experienced GPs will leave their work as a health centre physician. Moreover, several GP trainees do not consider health centre physician's work as a long-term career option. These trends may in the future reflect a recruiting problem in many primary health centres.
doi:10.1186/1471-2296-13-121 pmid:23249387 pmcid:PMC3553043 fatcat:vujwhveg4nd7hljqtcp5fulno4

Predictors of physicians' stress related to information systems: a nine-year follow-up survey study

Tarja Heponiemi, Hannele Hyppönen, Sari Kujala, Anna-Mari Aalto, Tuulikki Vehko, Jukka Vänskä, Marko Elovainio
2018 BMC Health Services Research  
Among the important stress factors for physicians nowadays are poorly functioning, time consuming and inadequate information systems. The present study examined the predictors of physicians' stress related to information systems (SRIS) among Finnish physicians. The examined predictors were cognitive workload, staffing problems, time pressure, problems in teamwork and job satisfaction, adjusted for baseline levels of SRIS, age, gender and employment sector. Methods: The study has a follow-up
more » ... gn with two survey data collection waves, one in 2006 and one in 2015, based on a random sample of Finnish physicians was used. The present study used a sample that included 1109 physicians (61.9% women; mean age in 2015 was 54.5; range 34-72) who provided data on the SRIS in both waves. The effects of a) predictor variable levels in 2006 on SRIS in 2015 and b) the change in the predictor variables from 2006 to 2015 on SRIS in 2015 were analysed with linear regression analyses. Results: Regression analyses showed that the higher level of cognitive workload in 2006 significantly predicted higher level of SRIS in 2015 (β = 0.08). The reciprocity of this association was tested with cross-lagged structural equation model analyses which showed that the direction of the association was from cognitive workload to SRIS, not from SRIS to cognitive workload. Moreover, increases in time pressure (β = 0.16) and problems in teamwork (β = 0.10) were associated with higher levels of SRIS in 2015, whereas job satisfaction increase was associated with lower SRIS (β = − 0.06). Conclusions: According to our results, physicians' cognitive workload may have long-lasting negative ramifications in regard to how stressful physicians experience their health information systems to be. Thus, organisations should pay attention to physicians workload if they wish physicians to master all the systems they need to use. It is also important to provide physicians with enough time and collegial support in their system-related problems, and in learning new systems and system updates.
doi:10.1186/s12913-018-3094-x pmid:29653530 pmcid:PMC5899365 fatcat:6iepg3xm3ba65jqpgwbl6lm7du

The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions: the buffering effect of job control

Tarja Heponiemi, Anne Kouvonen, Marianna Virtanen, Jukka Vänskä, Marko Elovainio
2014 BMC Health Services Research  
M. (2014). The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions: the buffering effect of job control. Abstract Background: Health care professionals, including physicians, are at high risk of encountering workplace violence. At the same time physician turnover is an increasing problem that threatens the functioning of the health care sector worldwide. The present study examined the prospective associations of work-related physical violence and
more » ... lying with physicians' turnover intentions and job satisfaction. In addition, we tested whether job control would modify these associations. Methods: The present study was a 4-year longitudinal survey study, with data gathered in 2006 and 2010.The present sample included 1515 (61% women) Finnish physicians aged 25-63 years at baseline. Analyses of covariance (ANCOVA) were conducted while adjusting for gender, age, baseline levels, specialisation status, and employment sector. Results: The results of covariance analyses showed that physical violence led to increased physician turnover intentions and that both bullying and physical violence led to reduced physician job satisfaction even after adjustments. We also found that opportunities for job control were able to alleviate the increase in turnover intentions resulting from bullying. Conclusions: Our results suggest that workplace violence is an extensive problem in the health care sector and may lead to increased turnover and job dissatisfaction. Thus, health care organisations should approach this problem through different means, for example, by giving health care employees more opportunities to control their own work.
doi:10.1186/1472-6963-14-19 pmid:24438449 pmcid:PMC3898009 fatcat:unrab6o2vzbu7glw4sz5s2ojli

Effects of active on-call hours on physicians' turnover intentions and well-being

Tarja Heponiemi, Anne Kouvonen, Jukka Vänskä, Hannu Halila, Timo Sinervo, Mika Kivimäki, Marko Elovainio
2008 Scandinavian Journal of Work, Environment and Health  
Objectives This study examined whether active on-call hours and the co-occurrence of lifestyle risk factors are associated with physicians' turnover intentions and distress. Methods Cross-sectional survey data on randomly selected female (N=1571) and male (N=1081) physicians, aged 25 to 65 years, from The Finnish Health Care Professionals Study were used. The outcome measures were turnover intentions and distress (general health questionnaire). Smoking, heavy drinking, overweight, and low
more » ... al activity were assessed as lifestyle risk factors. Analyses of covariance were used to analyze the data. Results After adjustment for gender, age, employment sector, and job satisfaction, the analyses showed that the physicians who had been on active call more than 40 hours per month reported more distress than the group not on call (P=0.046). The physicians with two or more risk factors also had more distress (P<0.001) than those with no risk factors or only one risk factor. There was an interaction between active on-call hours and lifestyle risk factors for turnover intentions (P=0.002). The physicians with two or more lifestyle risk factors who had been on active call more than 40 hours per month had more turnover intentions than the other physicians. Conclusions On-call duty and the co-occurrence of lifestyle risk factors may both decrease physicians' well being and increase their intentions to leave their job.
doi:10.5271/sjweh.1278 fatcat:dmkkhq4vtzg5zlgpoej3djm24m

Use of quality improvement methods in Finnish health centres in 1998 and 2003

Markku Sumanen, Irma Virjo, Harri Hyppölä, Hannu Halila, Esko Kumpusalo, Santero Kujala, Mauri Isokoski, Jukka Vänskä, Kari Mattila
2008 Scandinavian Journal of Primary Health Care  
Objective. To evaluate how widely quality improvement methods are used in Finnish primary health centres and how the use has changed over five years. Design. Two national cross-sectional postal enquiries. Setting and subjects. The questionnaire in 1998 was sent to every other physician graduated during the years 1977Á1986, and the questionnaire in 2003 to every other physician graduated during the years 1982Á1991. The response rates were 73.9% and 62.2%. The answers of primary healthcare
more » ... ans (n0503 vs. 344) were analysed. Main outcome measures. The availability of 13 quality improvement methods was solicited. The change over five years was analysed. Results. Opportunity to obtain continuing medical education (CME), in-service training, meetings, opportunity to consult a colleague in own speciality, and agreed guidelines on how a certain problem should be solved were highly reported both in 1998 and 2003. The biggest improvement (16.8%) concerned clinical guidelines. There was also progress with regard to quality improvement manuals at the place of work, opportunity to consult a colleague in another speciality, and computer-assisted monitoring of own work. Conclusion. Many quality improvement methods were highly reported in both 1998 and 2003 in Finnish health centres. The biggest positive change concerns clinical guidelines.
doi:10.1080/02813430701708598 pmid:18297557 pmcid:PMC3406621 fatcat:rxv5qzhoa5gbnhj3laaynwpvku

Usability factors associated with physicians' distress and information system-related stress: A cross-sectional survey study (Preprint)

Tarja Heponiemi, Sari Kujala, Suvi Vainiomäki, Tuulikki Vehko, Tinja Lääveri, Jukka Vänskä, Eeva Ketola, Sampsa Puttonen, Hannele Hyppönen
2019 JMIR Medical Informatics  
Constantly changing and difficult-to-use information systems have arisen as a significant source of stress in physicians' work. Physicians have reported several usability problems, system failures, and a lack of integration between the systems and have experienced that systems poorly support the documentation and retrieval of patient data. This stress has kept rising in the 21st century, and it seems that it may also affect physicians' well-being. This study aimed to examine the associations of
more » ... (1) usability variables (perceived benefits, technical problems, support for feedback, and user-friendliness), (2) the number of systems in daily use, (3) experience of using information systems, and (4) participation in information systems development work with physicians' distress and levels of stress related to information systems (SRIS) levels. A cross-sectional survey was conducted among 4018 Finnish physicians (64.82%, 2572 out of 3968 women) aged between 24 and 64 years (mean 46.8 years) in 2017. The analyses of covariance were used to examine the association of independent variables with SRIS and distress (using the General Health Questionnaire) adjusted for age, gender, employment sector, specialization status, and the electronic health record system in use. High levels of technical problems and a high number of systems in daily use were associated with high levels of SRIS, whereas high levels of user-friendliness, perceived benefits, and support for feedback were associated with low levels of SRIS. Moreover, high levels of technical problems were associated with high levels of psychological distress, whereas high levels of user-friendliness were associated with low distress levels. Those who considered themselves experienced users of information systems had low levels of both SRIS and distress. It seems that by investing in user-friendly systems with better technical quality and good support for feedback that professionals perceive as being beneficial would improve the work-related well-being and overall well-being of physicians. Moreover, improving physicians' skills related to information systems by giving them training could help to lessen the stress that results from poorly functioning information systems and improve physicians' well-being.
doi:10.2196/13466 pmid:31687938 pmcid:PMC6913751 fatcat:shs32rbcffes3einwi6uu5wpgm

Usability problems do not heal by themselves: National survey on physicians' experiences with EHRs in Finland

Johanna Kaipio, Tinja Lääveri, Hannele Hyppönen, Suvi Vainiomäki, Jarmo Reponen, Andre Kushniruk, Elizabeth Borycki, Jukka Vänskä
2017 International Journal of Medical Informatics  
Jukka Vänskä (M.Soc.Sci) was responsible for coordinating the survey project and he contributed to the statistical analysis. while the corresponding figure in 2010 was 14 411.  ...  Author's contribution Authors Johanna Kaipio, Tinja Lääveri, Hannele Hyppönen, Suvi Vainiomäki, Jarmo Reponen and Jukka Vänskä contributed to the study design, questionnaire development, data interpretation  ... 
doi:10.1016/j.ijmedinf.2016.10.010 pmid:27919385 fatcat:dis6tl4isjc4nms5x64yo4e47q
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